Gout

Gout is a disease caused by the deposition of monosodium urate (MSU) crystals in tissue such as cartilage, synovial membranes, bones and skin which causes inflammation in the synovial tissue. Indomethacin is first line of drug used as NSAID for the treatment of Gout. The aim of this study was to encapsulate Indomethacin in ethyl cellulose microspheres and compare the efficiency of the formulated Indomethacin microspheres with the Marketed formulation. Indomethacin microspheres were prepared by solvent evaporation method. FTIR  studies revealed there was no significant interaction between the drug and polymer. Preformulation studies gave satisfactory results. SEM studies showed a spherical smooth microsphere average size of 10.4±3.04. The percentage entrapment efficiency and percentage drug release after 10 hours was found to be 82.97±1.6 % and 52.04±0.58 % respectively. The therapeutic effect of the Indomethacin microspheres was evaluated by the swelling of knee joints, joint range of motion and histologic analysis of MSU induced rat model. The prepared indomethacin microspheres showed effective prolong in the retention time of the drug in the intra articular cavity to 30 d which is more than that of the marketed formulation. Intra- articular injection of Indomethacin microspheres efficiently relieved inflammatory symptoms such as swelling index, joint range motion and suppressed inflammatory cell infiltration than the marketed formulation. Thus intra-articular injection of Indomethacin loaded microspheres proved to be a promising therapeutic method in the treatment of Gout.

The Unani medicines have proven its own importance regarding its affectivity, cost and minimal side effects for many illnesses. The general treatment of Gout in Unani system of medicine (USM) comprises of moderating the alter humours (akhlat), excretion of excessive & altered humours, correction of digestion & regulation of metabolism and subside the local inflammation. For this purpose, the medicines having properties like, demulcent (mulattif), concoctive (munzij), diuretic (mudir-e-boul), digestive tonic (muqawwi-e-meda) and anti-inflammatory (muhallil-e-auram) are used. There are so many drugs to treat Gout without causing any side effect but most of these drugs have not been studied on modern scientific parameters, so keeping the fact in mind the formulation comprises of drugs Chobchini (Smilax china), Surinjan Shirin  (Colchicum latium), Sibr (Aloe barbadenesis) has been tested for gout treatment. It is an open clinical trial; conducted on 60 patients for duration of 60 days. Findings were recorded on a specially designed chart and inference was made by appropriate statistical analysis (Paired ‘t’ test). This result suggesting the effect of test drug is very effective in lowering the serum uric acid. Findings of trial were recorded on a specially designed chart and inference was made by appropriate statistical analysis.

The concept of hyperuricemia has not been described at all in Unani system of medicine, but description of a joint disorder known as Niqris, has been found in most of the classical Unani texts. The clinical features of Niqris very much resemble with the Gout as described in Allopathy, which occurs due to hyperuricemia. In practice, hyperuricemia is frequently defined as a serum urate levels exceeding of 7mg/dl (0.42 mmol/l) in adult males and 6 mg/dl (0.36 mmol/l) in adult females. However, this arbitrary definition of Hyperuricemia has been justified by epidemiological studies showing that those with SUA levels greater than 7mg/dl are at increased risk of developing gouty arthritis and urolithiasis. Hyperuricemia is fairly common, with a prevalence ranging between 2.3 to 41.4 percent in various populations. A variety of factors appear to be associated with higher serum urate concenterations. The present study was conducted on 50 patients of Primary Hyperuricemia attending the OPD of Ajmal Khan Tibbiya College and Hospital. During the study it was observed that the mean serum uric acid level, which was 8.6±1.1before the beginning of the study got reduced to 6.6±1.3 at the end of the study. As we applied paired “t” test to the observations recorded before and after treatment it was found that t=12.6, p